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Urine and Urination

Your kidneys make urine by filtering wastes and extra water from your blood. The waste is called urea. Your blood carries it to the kidneys. From the kidneys, urine travels down two thin tubes called ureters to the bladder. The bladder stores urine until you are ready to urinate. It swells into a round shape when it is full and gets smaller when empty. If your urinary system is healthy, your bladder can hold up to 16 ounces (2 cups) of urine comfortably for 2 to 5 hours.

You may have problems with urination if you have:

  • Kidney failure
  • Urinary tract infections
  • An enlarged prostate
  • Bladder control problems like incontinence, overactive bladder, or interstitial cystitis
  • A blockage that prevents you from emptying your bladder

Some conditions may also cause you to have blood or protein in your urine. If you have a urinary problem, see your health care provider. Urinalysis and other urine tests can help to diagnose the problem. Treatment depends on the cause.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Vaccines

What are vaccines?

Vaccines are injections (shots), liquids, pills, or nasal sprays that you take to teach your body's immune system to recognize and defend against harmful germs. For example, there are vaccines to protect against diseases caused by:

  • Viruses, like the ones that cause the flu and COVID-19
  • Bacteria, including tetanus, diphtheria, and pertussis
What are the types of vaccines?

There are several types of vaccines:

  • Live-attenuated vaccines use a weakened form of the germ.
  • Inactivated vaccines use a killed version of the germ.
  • Subunit, recombinant, polysaccharide, and conjugate vaccines use only specific pieces of the germ, such as its protein, sugar, or casing.
  • Toxoid vaccines use a toxin (harmful product) made by the germ.
  • mRNA vaccines use messenger RNA, which gives your cells instructions for how to make a protein (or piece of a protein) of the germ.
  • Viral vector vaccines use genetic material, which gives your cells instructions for making a protein of the germ. These vaccines also contain a different, harmless virus that helps get the genetic material into your cells.

These vaccines may work in different ways, but they all spark an immune response. The immune response is the way your body defends itself against substances it sees as foreign or harmful. These substances include germs that can cause disease.

What happens in an immune response?

There are different steps in the immune response:

  • When a germ invades, your body sees it as foreign.
  • Your immune system helps your body fight off the germ.
  • Your immune system also remembers the germ. It will attack the germ if it ever invades again. This "memory" protects you against the disease that the germ causes. This type of protection is called immunity.
What are immunization and vaccination?

Immunization is the process of becoming protected against a disease. But it can also mean the same thing as vaccination, which is getting a vaccine to become protected against a disease.

Why are vaccines important?

Vaccines are important because they protect you against many diseases. These diseases can be very serious. So getting immunity from a vaccine is safer than getting immunity by being sick with the disease.

For a few vaccines, getting vaccinated can actually give you a better immune response than getting the disease would.

But vaccines don't just protect you. They also protect the people around you through community immunity.

What is community immunity?

Community immunity, or herd immunity, is the idea that vaccines can help keep communities healthy.

Normally, germs can travel quickly through a community and make a lot of people sick. If enough people get sick, it can lead to an outbreak. But when enough people are vaccinated against a certain disease, it's harder for that disease to spread to others. This type of protection means that the entire community is less likely to get the disease.

Community immunity is especially important for people who can't get certain vaccines. For example, they may not be able to get a vaccine because they have weakened immune systems. Others may be allergic to certain vaccine ingredients. And newborn babies are too young to get some vaccines. Community immunity can help to protect them all.

Are vaccines safe?

Vaccines are safe. They must go through extensive safety testing and evaluation before they are approved in the United States.

What is a vaccine schedule?

A vaccine, or immunization, schedule lists which vaccines are recommended for different groups of people. It includes who should get the vaccines, how many doses they need, and when they should get them. In the United States, the Centers for Disease Control and Prevention (CDC) publishes the vaccine schedule.

It's important for both children and adults to get their vaccines according to the schedule. Following the schedule allows them to get protection from the diseases at exactly the right time.

Vascular Diseases

What are vascular diseases?

Your vascular system is your body's network of blood vessels. It includes your:

  • Arteries, which carry oxygen-rich blood from your heart to your tissues and organs
  • Veins, which carry the blood and waste products back to your heart
  • Capillaries, which are tiny blood vessels that connect your small arteries to your small veins. The walls of the capillaries are thin and leaky, to allow for an exchange of materials between your tissues and blood.

Vascular diseases are conditions which affect your vascular system. They are common and can be serious. Some types include:

  • Aneurysm - a bulge or "ballooning" in the wall of an artery
  • Atherosclerosis - a disease in which plaque builds up inside your arteries. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood.
  • Blood clots, including deep vein thrombosis and pulmonary embolism
  • Coronary artery disease and carotid artery disease, diseases that involve the narrowing or blockage of an artery. The cause is usually a buildup of plaque.
  • Raynaud phenomenon - a disorder that causes the blood vessels to narrow when you are cold or feeling stressed
  • Stroke - a serious condition that happens when blood flow to your brain stops.
  • Varicose veins - swollen, twisted veins that you can see just under the skin
  • Vasculitis - inflammation of the blood vessels
What causes vascular diseases?

The causes of vascular diseases depend on the specific disease. These causes include:

  • Genetics
  • Heart diseases such as high cholesterol and high blood pressure
  • Infection
  • Injury
  • Medicines, including hormones

Sometimes the cause is unknown.

Who is at risk for vascular diseases?

The risk factors for vascular diseases can vary, depending on the specific disease. But some of the more common risk factors include:

  • Age - your risk of some diseases goes up as you get older
  • Conditions that can affect the heart and blood vessels, such as diabetes or high cholesterol
  • Family history of vascular or heart diseases
  • Infection or injury that damages your veins
  • Lack of exercise
  • Obesity
  • Pregnancy
  • Sitting or standing still for long periods of time
  • Smoking
What are the symptoms of vascular diseases?

The symptoms for each disease are different.

How are vascular diseases diagnosed?

To make a diagnosis, your health care provider will do a physical exam and ask about your symptoms and medical history. You may have imaging tests and/or blood tests.

How are vascular diseases treated?

Which treatment you get depends on which vascular disease you have and how severe it is. Types of treatments for vascular diseases include:

  • Lifestyle changes, such as eating a heart-healthy diet and getting more exercise
  • Medicines, such as blood pressure medicines, blood thinners, cholesterol medicines, and clot-dissolving drugs. In some cases, providers use a catheter to send medicine directly to a blood vessel.
  • Non-surgical procedures, such as angioplasty, stenting, and vein ablation
  • Surgery
Can vascular diseases be prevented?

There are steps you can take to help prevent vascular diseases:

  • Make healthy lifestyle changes, such as eating a heart-healthy diet and getting more exercise
  • Don't smoke. If you are already a smoker, talk to your health care provider for help in finding the best way for you to quit.
  • Keep your blood pressure and cholesterol in check
  • If you have diabetes, control your blood sugar
  • Try not to sit or stand for up long periods of time. If you do need to sit all day, get up and move around every hour or so. If you are traveling on a long trip, you can also wear compression stockings and regularly stretch your legs.

Weight Loss Surgery

Weight loss surgery helps people with extreme obesity to lose weight. It may be an option if you cannot lose weight through diet and exercise or have serious health problems caused by obesity.

There are different types of weight loss surgery. They often limit the amount of food you can take in. Some types of surgery also affect how you digest food and absorb nutrients. All types have risks and complications, such as infections, hernias, and blood clots.

Many people who have the surgery lose weight quickly, but regain some weight later on. If you follow diet and exercise recommendations, you can keep most of the weight off. You will also need medical follow-up for the rest of your life.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Wilson Disease

Wilson disease is a rare inherited disorder that prevents your body from getting rid of extra copper. You need a small amount of copper from food to stay healthy. Too much copper is poisonous.

Normally, your liver releases extra copper into bile, a digestive fluid. With Wilson disease, the copper builds up in your liver, and it releases the copper directly into your bloodstream. This can cause damage to your brain, kidneys, and eyes.

Wilson disease is present at birth, but symptoms usually start between ages 5 and 35. It first attacks the liver, the central nervous system or both. The most characteristic sign is a rusty brown ring around the cornea of the eye. A physical exam and laboratory tests can diagnose it.

Treatment is with drugs to remove the extra copper from your body. You need to take medicine and follow a low-copper diet for the rest of your life. Don't eat shellfish or liver, as these foods may contain high levels of copper. At the beginning of treatment, you'll also need to avoid chocolate, mushrooms, and nuts. Have your drinking water checked for copper content and don't take multivitamins that contain copper.

With early detection and proper treatment, you can enjoy good health.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

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